Organization Active NPI

Prime Health Solutions LLC

  • Primary Care Clinic/Center
  • Lyman, SC
National Provider Identifier
1861907925
Registry record updated Dec 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PRIME HEALTH SOLUTIONS LLC
Practice address
206 Elliott Rd
Lyman, SC 29365-1620
Phone
(864) 485-2172
NPI assigned
Dec 11, 2017
Last updated
Dec 11, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Duveen Woolbright, FNP-BCNPI 1215062088
Title
Owner/Ceo
Phone
(864) 485-2172

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

206 Elliott Rd
Lyman, SC 29365-1620

Mailing address

206 Elliott Rd
Lyman, SC 29365-1620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180206000937 SC Part B Supplier - Clinic/Group Practice 4183984479 Receives reassigned benefits from 2 practitioners
Practice locations: Lyman, SC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
42D2129521Prime Health Solutions, LLC206 Elliott Road, Lyman, SC 29365Certificate of waiverDec 2, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512950400000",
    "number": "1861907925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 ELLIOTT RD",
            "city": "LYMAN",
            "state": "SC",
            "postal_code": "293651620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 ELLIOTT RD",
            "city": "LYMAN",
            "state": "SC",
            "postal_code": "293651620",
            "telephone_number": "864-485-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTH SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-11",
        "last_updated": "2017-12-11",
        "status": "A",
        "authorized_official_last_name": "WOOLBRIGHT",
        "authorized_official_first_name": "DUVEEN",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "864-485-2172",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lyman, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.